When the News Isn't Good

by:

Rachel Davidson

Source:

Caregiver's Home Companion

Published:

07/31/2009

When she learned that her father’s best friend had died, Pat Warden didn’t know whether she should tell her dad. “He lost his wife last year and was just beginning to act like his old self.” Warden, of Waukesa, Wisconsin, explains.

While no one likes receiving bad news, most family elder-caregivers find it even more unpleasant sharing this information with their aging loved ones. In fact, in an effort to protect them, some caregivers outright withhold negative information.

Stronger Than Perceived

Dr. Chip Long of Little Rock, Arkansas, is a staff psychologist at Central Arkansas VA Medical Center. He says, “A lot of people get nervous when they have to break bad news to the elderly. They shy away from doing it because they’re concerned about the emotional response that person is going to have. Are they going to be upset, cry, whatever?”

“People tend to see the elderly as frail, weak persons,” adds Marion Somers, a geriatric care manager, professor, consultant and caregiver with more than 30 years of eldercare experience.

Their professional experiences with older adults have taught them to think differently about our loved ones’ reactions. “The elderly are far more resilient than they’re given credit for,” says Somers. “You don’t get to be 80 years old without learning a few lessons from the world of hard knocks.”

Long agrees. “At some point, they’ve come to a point of dealing with hard issues. Yes, telling them will be difficult, but they have a unique set of coping strategies to handle it.”

When They’re Cognitively Impaired

Both Somers and Long believes in being honest and straightforward with our aging loved ones. However, “When considering how you tell them, you need to factor in how cognitively impaired they are,” Long emphasizes.

Somers adds her experience: “I believe there is intelligence working until the day we die, even if we’re stuck in a body that’s not communicating. I always talk to people with dementia as though they are hearing me. I sit right in front of them so we have eye contact. I take their hands and say. ‘I have bad news for you.’ This gets their attention. Then I proceed to tell them what happened factually and to the point.”

Long’s approach is more circumspect. “If there is some dementia or a tendency to forget things, you still need to try to make the effort,” he says. “After that initial attempt, if it continues to come up because they don’t remember or can’t grasp it, let it go. Constantly reminding them can be overwhelming.”

How and where you tell your loved ones is extremely important, even if they’re not cognitively challenged. “Find a quiet place and limit distractions,” Long advises.

Somers builds on that point: “Keep your emotions out of it, because they are going to have their own reaction to the news. You want to know how they’re feeling. If you go in with your perceptions, they’re not only going to have their emotions, but also yours, which is going to exacerbate their feelings.”

Long describes the possible outcomes this way: “They may cry or become upset. There may not be any reaction at all. Be ready to support and work with them, whatever their actions might be.”

Pat Warden’s father thanked her when she told him what had happened. “It was for the best,” she said he told her. “He told me that he didn’t have anything to live for anymore.”

Long believes families should take the lead in sharing information with their loved ones, whenever possible. “If you can, include family members,” he urges. “When he’s surrounded by people he’s comfortable with and that have a special connection to him, he can deal better with those kinds of things.”

Somers says she has often had to deliver the bad news herself, when family members couldn’t be there. ‘Whenever possible,” she says, “I bring a picture of the person who just passed on. ‘The family wanted you to have this.’ If they’re spiritual, I’ll say, ‘The family wanted you to include them in your prayers.’ Or I may ask them if they want to go to our chapel.”

“After giving them the bad news, I always stay at least half an hour, preferably more, so I can respond to their reaction. IF I think there is going to be a problem, I may ask the rabbi to join us.”

If they are able to get out of the nursing home or other environment for part of a day and would benefit from attending the wake or funeral, Somers recommends telling them before the funeral so they can attend and mourn with the family. “If they’re not able to be there, I wouldn’t say anything until immediately afterwards,” she says. “I’d tell them, ‘It all happened so quickly.’”

When It’s Over

Many caregivers fear their elderly loved ones will withdraw and become depressed about their own death after hearing the bad news. However, Somers says older adults want to discuss their own mortality, and this provides a springboard. She explains, “They say things like, ‘I know I’m going to die, but nobody wants to talk with me about it.’ I talk to them about it all the time. ‘Do you have any concerns?’ ‘Is there anything I can do to help you?’”

Your loved one will continue to need your compassionate care after the funeral too. “Letting them share whatever emotion they might be having and giving them permission to talk is one of the most powerful things you can do for someone afterwards,” Long notes. “Even if they’re not ready at the moment, just letting them know that you’re available later is a huge outlet for them.”

In sum, leading elder care professionals agree that by allowing your loved one to participate in all aspects of life, both good and bad, you are sharing the grieving process and drawing closer to each other.